New home semen analysis test about to hit stores - but watch out!
At first glance you would think this is a good thing - being able to know more about yourself, specifically your sperm count. And many tens of thousands of men, I am sure, will buy and use this home sperm count test. Unfortunately they, like so many others, will be making a huge mistake by incorrectly assuming that normal numbers mean all is well and low numbers suggest poor fertility. The truth is that a semen analysis is NOT a test of male fertility. It is a test of only 2 things - sperm production and sperm delivery. A semen analysis is a good way to make an educated guess about a male's fertility status, but it is not precise and many men with low counts have no problems fathering children. Likewise, we see men with great numbers who are simply unable to make a baby. There is so much more to fertility and conception that sperm counts.
Can we just have one child?
This is common question raised by many couples considering vasectomy reversal. The answer -yes, of course you can. It is important to remember that a well performed vasectomy reversal by a true expert is about 1/3 the cost of in-vitro fertilization with ICSI and more effective. If, after having you single child you are no longer interested in fathering any more children, then you can easily have a vasectomy without any additional problems or risks. In fact, vasectomies are commonly performed on men who, after their reversal, are done and ready to move back to the “no more children” phase of life.
"It's not in my head - this pain is real!"
Pain after vasectomy is a rare and devastating side effect from a vasectomy. Almost without exception, every single vasectomy pain patient whom I talk with tells me how their doctors repeatedly told them that their pain was "not real", was really "psychosomatic" or was from an emotional need for attention or a "drug-seeking behavior." In essence, they were being told that their pain was not really there and that in fact they were crazy as there were no physical causes of pain after vasectomy. There are many post-vasectomy pain patients that are even told that Post Vasectomy Pain Syndrome (PVPS) doesn't exist, and so go far as to tell the patient that they have never heard of such a syndrome. Yet this syndrome of severe or chronic pain after vasectomy is well known and clearly described in the medical literature, and has been so for many years. The problem is that the doctor you are seeing may not be aware or educated on this rare complication of vasectomy. When I counsel patients about vasectomy, I am always certain to explain in my review of potential complications that PVPS does exist. I explain further to this patient considering a vasectomy than when this pain after vasectomy occurs, it can be severe, unrelenting and life-destroying.
Vasectomy reversal experts or not
So often I hear or read about patients who are considering our full-time vasectomy reversal only program as well as looking at a number of other vasectomy reversal "experts". When they tell me their final list, I am usually surprised that several of the doctors they are considering are often not vasectomy reversal experts at all. In fact, they are often busy general practice urologists who also do an occasional vasectomy reversal. What these doctors have so smartly done is to create an impressive image of expertise, often with a fancy website that pronounces their expertise and fame.
Hidden Costs of a Vasectomy Reversal
The out-of-pocket dollar costs for a vasectomy reversal are pretty straight-forward. That's a no-brainer. Assuming the doctor or facility is honest with you up-front, the price you are quoted is what you will pay. But costs for achieving fertility after a vasectomy through a microsurgical vasectomy reversal can be more than just money.
Buyer Beware or "The Big Lie"
At a recent meeting of most of the world's leading vasectomy reversal experts, there were a few moments of heated discussion about microsurgery courses offered to general urologists. The purpose of the course is to improve the level of care they provide. Makes sense. The question that was debated - does taking an introductory weekend course in microsurgery really qualify the doctor to be able to perform microsurgical vasectomy reversal procedures? Just as important, does it qualify the doctor to be able to advertise that he had formal microsurgery training and is therefore an expert?
Exercise probably does not impact on sperm counts and function
A new study out today suggests that exercise probably does not have an impact on sperm counts and function, unless, and this is a big unless, the man rides a bike more than 5 hours a week. How is this relevant to my vasectomy reversal patients? Well, performing a vasectomy reversal is all about restoring fertility, so this is highly relevant. After all, many of my patients do exercise regularly and some aggressively.
